APPLICATION FOR ATM FACILITY

( ATM CELL, UFFIZI COMPLEX-BASEMENT

338 AVINASHI ROAD, COIMBATORE 641004)

NAME OF THE BRANCH BRANCH CODE CUSTOMER ID DATE

NAME OF THE ACCOUNT: APPLICATION NO

ACCOUNT DATE OF
NUMBER BIRTH D D M M Y Y Y Y
ADDRESS
PLEASE
AFFIX STAMP
SIZE PHOTO

I have read and accepted the terms and conditions* ( a copy of which I am in possession of ) governing the opening of an account
with KVB and those relating to various services of VISA electron Debit Card including but not limited to (a) ATM
(b) POS Terminals.

CUSTOMER’S SIGNATURE OFFICER/ MANAGER’S SIGNATURE

*Branch may please ref frs.com

APPLICATION FOR ATM FACILITY

(ATM CELL, UFFIZI COMPLEX-BASEMENT
338 AVINASHI ROAD, COIMBATORE 641004)

NAME OF THE BRANCH BRANCH CODE CUSTOMER ID

DATE

NAME OF THE ACCOUNT: APPLICATION NO

ACCOUNT DATE OF D D M M Y Y Y Y
NUMBER BIRTH
ADDRESS
PLEASE
AFFIX STAMP
SIZE PHOTO

I have read and accepted the terms and conditions* ( a copy of which I am in possession of ) governing the opening of an account
with KVB and those relating to various services of VISA electron Debit Card including but not limited to (a) ATM
(b) POS Terminals

CUSTOMER’S SIGNATURE OFFICER/ MANAGER’S SIGNATURE

*Branch may please ref frs.com